Epicardial and Liver Fat Implications in Albuminuria: a Retrospective Study

Overview

Journal Cardiovasc Diabetol

Publisher Biomed Central

Specialties Cardiology & Vascular Diseases
Endocrinology

Date 2024 Aug 22

PMID 39175063

Authors

Carolina M Perdomo

Nerea Martin-Calvo

Ana Ezponda

Francisco J Mendoza

Gorka Bastarrika

Nuria Garcia-Fernandez

Jose I Herrero

Inmaculada Colina

Javier Escalada

Gema Fruhbeck

Affiliations

Soon will be listed here.

Abstract

Background: Albuminuria is considered an early and sensitive marker of kidney dysfunction, but also an independent cardiovascular risk factor. Considering the possible relationship among metabolic liver disease, cardiovascular disease and chronic kidney disease, we aimed to evaluate the risk of developing albuminuria regarding the presence of epicardial adipose tissue and the steatotic liver disease status.

Methods: A retrospective long-term longitudinal study including 181 patients was carried out. Epicardial adipose tissue and steatotic liver disease were assessed by computed tomography. The presence of albuminuria at follow-up was defined as the outcome.

Results: After a median follow up of 11.2 years, steatotic liver disease (HR 3.15; 95% CI, 1.20-8.26; p = 0.02) and excess amount of epicardial adipose tissue (HR 6.12; 95% CI, 1.69-22.19; p = 0.006) were associated with an increased risk of albuminuria after adjustment for visceral adipose tissue, sex, age, weight status, type 2 diabetes, prediabetes, hypertriglyceridemia, hypercholesterolemia, arterial hypertension, and cardiovascular prevention treatment at baseline. The presence of both conditions was associated with a higher risk of developing albuminuria compared to having steatotic liver disease alone (HR 5.91; 95% CI 1.15-30.41, p = 0.033). Compared with the first tertile of visceral adipose tissue, the proportion of subjects with liver steatosis and abnormal epicardial adipose tissue was significantly higher in the second and third tertile. We found a significant correlation between epicardial fat and steatotic liver disease (rho = 0.43 [p < 0.001]).

Conclusions: Identification and management/decrease of excess adiposity must be a target in the primary and secondary prevention of chronic kidney disease development and progression. Visceral adiposity assessment may be an adequate target in the daily clinical setting. Moreover, epicardial adipose tissue and steatotic liver disease assessment may aid in the primary prevention of renal dysfunction.

Citing Articles

The association between visceral fat metabolic score and stroke: mediation by declining kidney function.

Cao Y, Wen W, Zhang H, Li W, Huang G, Huang Y Diabetol Metab Syndr. 2025; 17(1):50.

PMID: 39920850 PMC: 11806899. DOI: 10.1186/s13098-025-01608-9.

References

Hu S, Li X, Sun Y, Wu S, Lan Y, Chen S . Short-term weight loss decreased the risk of chronic kidney disease in men with incident nonalcoholic fatty liver disease. Obesity (Silver Spring). 2022; 30(7):1495-1506. DOI: 10.1002/oby.23459. View

Muzurovic E, Peng C, Belanger M, Sanoudou D, Mikhailidis D, Mantzoros C . Nonalcoholic Fatty Liver Disease and Cardiovascular Disease: a Review of Shared Cardiometabolic Risk Factors. Hypertension. 2022; 79(7):1319-1326. DOI: 10.1161/HYPERTENSIONAHA.122.17982. View

Theofilis P, Vordoni A, Kalaitzidis R . Interplay between metabolic dysfunction-associated fatty liver disease and chronic kidney disease: Epidemiology, pathophysiologic mechanisms, and treatment considerations. World J Gastroenterol. 2022; 28(39):5691-5706. PMC: 9627426. DOI: 10.3748/wjg.v28.i39.5691. View

Hydes T, Kennedy O, Buchanan R, Cuthbertson D, Parkes J, Fraser S . The impact of non-alcoholic fatty liver disease and liver fibrosis on adverse clinical outcomes and mortality in patients with chronic kidney disease: a prospective cohort study using the UK Biobank. BMC Med. 2023; 21(1):185. PMC: 10193672. DOI: 10.1186/s12916-023-02891-x. View

Roderburg C, Krieg S, Krieg A, Demir M, Luedde T, Kostev K . Non-alcoholic fatty liver disease (NAFLD) is associated with an increased incidence of chronic kidney disease (CKD). Eur J Med Res. 2023; 28(1):153. PMC: 10108448. DOI: 10.1186/s40001-023-01114-6. View

Perdomo C, Garcia-Fernandez N, Escalada J . Diabetic Kidney Disease, Cardiovascular Disease and Non-Alcoholic Fatty Liver Disease: A New Triumvirate?. J Clin Med. 2021; 10(9). PMC: 8126096. DOI: 10.3390/jcm10092040. View

Agustanti N, Mulyani Soetedjo N, Damara F, Iryaningrum M, Permana H, Bestari M . The association between metabolic dysfunction-associated fatty liver disease and chronic kidney disease: A systematic review and meta-analysis. Diabetes Metab Syndr. 2023; 17(5):102780. DOI: 10.1016/j.dsx.2023.102780. View

Katsiki N, Mikhailidis D . Excessive "orthotopic" fat accumulation: Links with cardiometabolic diseases and potential drug treatment. J Cell Physiol. 2020; 235(9):6321-6322. DOI: 10.1002/jcp.29573. View

Byrne C, Targher G . NAFLD as a driver of chronic kidney disease. J Hepatol. 2020; 72(4):785-801. DOI: 10.1016/j.jhep.2020.01.013. View

10.

Cypess A . Reassessing Human Adipose Tissue. N Engl J Med. 2022; 386(8):768-779. DOI: 10.1056/NEJMra2032804. View

11.

Zhang H, Wang Y, Chen C, Lu Y, Wang N . Cardiovascular and renal burdens of metabolic associated fatty liver disease from serial US national surveys, 1999-2016. Chin Med J (Engl). 2021; 134(13):1593-1601. PMC: 8280082. DOI: 10.1097/CM9.0000000000001513. View

12.

Fruhbeck G, Catalan V, Rodriguez A, Ramirez B, Becerril S, Salvador J . Adiponectin-leptin Ratio is a Functional Biomarker of Adipose Tissue Inflammation. Nutrients. 2019; 11(2). PMC: 6412349. DOI: 10.3390/nu11020454. View

13.

Radaelli M, Martucci F, Perra S, Accornero S, Castoldi G, Lattuada G . NAFLD/NASH in patients with type 2 diabetes and related treatment options. J Endocrinol Invest. 2017; 41(5):509-521. DOI: 10.1007/s40618-017-0799-3. View

14.

Younossi Z . Non-alcoholic fatty liver disease - A global public health perspective. J Hepatol. 2018; 70(3):531-544. DOI: 10.1016/j.jhep.2018.10.033. View

15.

Pincu Y, Yoel U, Haim Y, Makarenkov N, Maixner N, Shaco-Levy R . Assessing Obesity-Related Adipose Tissue Disease (OrAD) to Improve Precision Medicine for Patients Living With Obesity. Front Endocrinol (Lausanne). 2022; 13:860799. PMC: 9098964. DOI: 10.3389/fendo.2022.860799. View

16.

Lonardo A, Mantovani A, Targher G, Baffy G . Nonalcoholic Fatty Liver Disease and Chronic Kidney Disease: Epidemiology, Pathogenesis, and Clinical and Research Implications. Int J Mol Sci. 2022; 23(21). PMC: 9654863. DOI: 10.3390/ijms232113320. View

17.

Katsiki N, Athyros V, Mikhailidis D . Abnormal Peri-Organ or Intra-organ Fat (APIFat) Deposition: An Underestimated Predictor of Vascular Risk?. Curr Vasc Pharmacol. 2016; 14(5):432-441. DOI: 10.2174/1570161114666160722112738. View

18.

Kalantar-Zadeh K, Jafar T, Nitsch D, Neuen B, Perkovic V . Chronic kidney disease. Lancet. 2021; 398(10302):786-802. DOI: 10.1016/S0140-6736(21)00519-5. View

19.

Mikolasevic I, Domislovic V, Ruzic A, Hauser G, Rahelic D, Klobucar-Majanovic S . Elastographic parameters of liver steatosis and fibrosis predict independently the risk of incident chronic kidney disease and acute myocardial infarction in patients with type 2 diabetes mellitus. J Diabetes Complications. 2022; 36(8):108226. DOI: 10.1016/j.jdiacomp.2022.108226. View

20.

Perdomo C, Dingianna P, Escalada J, Petta S, Gomez M, Ampuero J . Nonalcoholic fatty liver disease and the risk of metabolic comorbidities: how to manage in clinical practice. Pol Arch Intern Med. 2020; 130(11):975-985. DOI: 10.20452/pamw.15510. View